<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Form_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-form_type" data-rule="required" class="form-control" name="row[form_type]" type="text" value="coop">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Company_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-company_name" class="form-control" name="row[company_name]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Contactor')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-contactor" class="form-control" name="row[contactor]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Phone')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-phone" data-rule="required" class="form-control" name="row[phone]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Email')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-email" data-rule="required" class="form-control" name="row[email]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Feedback_note')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-feedback_note" data-rule="required" class="form-control" name="row[feedback_note]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Feedback_images')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-feedback_images" data-rule="required" class="form-control" size="50" name="row[feedback_images]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-feedback_images" class="btn btn-danger faupload" data-input-id="c-feedback_images" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="true" data-preview-id="p-feedback_images"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-feedback_images" class="btn btn-primary fachoose" data-input-id="c-feedback_images" data-mimetype="image/*" data-multiple="true"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-feedback_images"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-feedback_images"></ul>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
